Blogs

Are We Taking the Wrong Approach to Preventing Cavities?

The current state of dental healthcare in America has been described as an "epidemic" by numerous boards and committees. Are dentists providing a "band-aid solution" to a deeper problem?

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A Surprising New Look at Anxiety Treatment

Could a new treatment make dental fear a thing of the past? Researchers make a breakthrough in our understanding of anxiety and its etiology in the brain.

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Considerations for Patient Taking Cimzia

What's the best protocol when a patient is on medications with multiple uses? DOCS Faculty share advice for taking a medical history and evaluating drug interactions.

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Rectal Cancer Worsened by Oral Microbes, Research Indicates.

One of the deadliest cancers may be exacerbated by travelling bacteria from the oral cavity. A new study finds that fusobacteria localize to tumors in the lower intestine.

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Treating Elderly Patient with Colitis

Sedation can help to make older patients more comfortable during dental treatment, but accommodating medically-complex patients can be challenging depending on their condition.

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Root Tip Infections May Contribute to Heart Disease

A new study finds that hidden infections, such as those at the root tip, may predispose one to cardiovascular disease.

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Past Meth User Claims Intolerance to Triazolam

What are the options when a patient with a history of methamphetamine usage appears to be so resistant to benzodiazepines that they produce no effect? DOCS Education faculty weigh in.

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Too Early to Recommend EDTA Dental Gel as Toothpaste Replacement, Say Experts

Recently recommended by famed inventor Sir James Dyson, a new dental gel claims to be more effective than toothpaste with no abrasives, foam or antibiotics.

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Breaking the Biofilm: New Nanoparticle Shows Promise

Iron nanoparticles may disrupt the ability of cariogenic bacteria to form biofilms, paving the way for next-generation anticavity treatments.

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Sedating Patient on Morphine for Back Pain

A patient requests treatment under sedation, and discloses she has had two back surgeries with morphine as the principal painkiller. Can she safely be sedated per DOCS protocols?

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A member of DOCS Education needs clarification on what constitutes a sedation protocol, as well as the proper procedure for their patient.
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A member of DOCS Education asks:

I am showing some [D] interactions on Lexicomp for triazolam, diazepam, hydroxyzine and Ambien® as well as Norco®. We could skip the Ambien®, but I still have concerns about the Norco®. Any suggestions? This is a chronic pain patient.

Thanks


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A member of DOCS Education asks:

It seems I have an abundance of cops and nurses in the practice, and all seem to be taking some form of anti-anxiety meds or BP meds. Well, someone has to treat them and I have had great success with the DOCS protocol, but could use some suggestions here on an upcoming patient:

Patient is 5 9" / 220 lbs. He is a half-pack a day smoker. No snoring, or so he says. BP today was 148/89, HR 86'. I have seen diastolic pressure at 95 on a previous visit. Meds are as follows:


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A member of DOCS Education asks: My patient is a 21 year old female who presents for IV sedation and operative dentistry. She smokes 0.5 packs/day, reports she has bronchitis but has no medication for such. She also states she takes Depakote® for bipolar disorder and Propranolol for tachycardia. Lexicomp shows no interactions with the Depakote® and only a C rating for Fentanyl (a non-benzodiazepine) and Propranolol. No other interactions are listed.
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A Member of DOCS Education asks: The Sedation Dentistry Guidebook offers a form titled "Sedation Appointment Checklist." The checklist outlines some instructions specifically for smokers, specifically how long to refrain from smoking after a sedation appointment. To clarify, are we to use this form to communicate to patients how long they are not to smoke before their sedation appointment? I remember from the DOCS course that smokers were encouraged to smoke before and throughout the sedation appointment as needed. Do we offer this option to all patients that smoke, or only to those who smoke beyond a specific threshold of cigarettes per day? Off of that, what is the protocol for allowing a patient to smoke during the sedation appointment? Should we keep the pulse ox attatched to the patient and accompany them outside? Any clarification would be appreciated?
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A DOCS Education member brings this question to the forum: I would appreciate some input regarding this patient, a 56 year old female, 5 feet and 1.5 inches tall, 248 lbs. She is a non-smoker. I have an upcoming treatment appointment with her and I plan on using a Triazolam titration protocol with her starting with .25 mg of Triazolam one hour prior to her appointment. She reports the following medical conditions: Hypertension Diabetes Asthma Hay Fever Hypothyroidism Fibromyalgia
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